{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:53:15Z","timestamp":1777312395410,"version":"3.51.4"},"reference-count":80,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025]]},"abstract":"\n Background:<\/jats:bold>\n Type 2 diabetes mellitus (T2DM) requires significant patient involvement, with health literacy playing a crucial role in patients\u2019 ability to navigate their care. Qatar has one of the highest T2DM prevalence rates globally, yet research on health literacy in this population remains limited. The purpose of this study was to evaluate health literacy levels and predictors among Type 2 diabetes patients in Qatar.\n <\/jats:p>\n \n Methods:<\/jats:bold>\n An analytical cross-sectional study was conducted, targeting patients diagnosed with type 2 diabetes. A total of 450 patients were randomly sampled, and data were collected through structured interviews using the European Health Literacy Survey Questionnaire - short version (HLS-EU-Q16) to measure health literacy. In addition to determining the prevalence of different health literacy levels, associations between health literacy and patient characteristics were examined using bivariate analysis. A regression model was employed to identify independent predictors of health literacy.\n <\/jats:p>\n \n Results:<\/jats:bold>\n Of the 450 participants, 57.8% were male with a mean age of 51.6 years. 62.4 % demonstrated sufficient health literacy, 31.8 % problematic, and 5.8 % inadequate levels. Health literacy was significantly associated with participants\u2019 age, education, occupation, income, living situation, diabetes duration, treatment, and complications (\n P<\/jats:italic>\n < 0.05). Multivariable analysis showed that primary (adjusted odds ratio (AOR), 0.080;\n P<\/jats:italic>\n < 0.001), no formal (AOR, 0.162;\n P<\/jats:italic>\n = 0.008) and secondary education (AOR, 0.266;\n P<\/jats:italic>\n = 0.001) each reduced the odds of higher literacy versus university education, while living with family (AOR, 2.843;\n P<\/jats:italic>\n = 0.030) and being managed with oral medications alone (AOR, 3.230;\n P<\/jats:italic>\n = 0.004) or no medication (AOR, 11.196;\n P<\/jats:italic>\n = 0.038) increased the odds.\n <\/jats:p>\n \n Conclusion:<\/jats:bold>\n Although a high proportion of patients had sufficient health literacy, many still struggled with problematic or inadequate levels, especially those with lower education or complex insulin regimens. Routine health literacy assessment and targeted, culturally appropriate education for high-risk groups should be embedded in diabetes services and national strategies.\n <\/jats:p>","DOI":"10.5339\/qmj.2025.104","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T13:30:29Z","timestamp":1764768629000},"source":"Crossref","is-referenced-by-count":0,"title":["Health literacy levels and predictors among type 2 diabetes patients in Qatar: An analytical cross-sectional study"],"prefix":"10.5339","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8227-5961","authenticated-orcid":true,"given":"Mohamad","family":"Alchawa","sequence":"first","affiliation":[{"name":"Preventive Health, Primary Health Care Corporation, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rana","family":"Alasaad","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Endocrinology, West Bay Medicare, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jihene Maatoug","family":"Maaloul","sequence":"additional","affiliation":[{"name":"Community Medicine Department, Primary Health Care Corporation, Doha, Qatar"},{"name":"Faculty of Medicine, Sousse University, Sousse, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Zirie","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar*Correspondance: Mohamad Alchawa malchawa@phcc.gov.qa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iheb","family":"Bougmiza","sequence":"additional","affiliation":[{"name":"Community Medicine Department, Primary Health Care Corporation, Doha, Qatar"},{"name":"Faculty of Medicine, Sousse University, Sousse, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"key":"B1","series-title":"Diabetes Fact Sheet","author":"World Health Organization","year":"2021"},{"key":"B2","series-title":"Urgent action needed as global diabetes cases increase four-fold over past decades","author":"World Health Organization"},{"key":"B3","series-title":"Diabetes Res Clin Pract","first-page":"271\u201381","article-title":"IDF Diabetes Atlas: global estimates of diabetes prevalence for 2017 and projections for 2045","volume":"138","author":"Cho\n \nNH","year":"2018"},{"key":"B4","series-title":"Global Diabetes Data & Insights","article-title":"IDF Diabetes Atlas 2025 |","author":"International Diabetes Federation","year":"2025"},{"key":"B5","series-title":"Diabetes Res Clin Pract","first-page":"100\u20138","article-title":"Forecasting the burden of type 2 diabetes mellitus in Qatar to 2050: a novel modeling approach","volume":"137","author":"Awad\n \nSF","year":"2018"},{"issue":"(10):","key":"B6","series-title":"PLoS One","first-page":"e0259152","article-title":"Characterizing epidemiology of prediabetes, diabetes, and hypertension in Qataris: a cross-sectional study","volume":"16","author":"Al-Thani\n \nMH","year":"2021"},{"issue":"(4):","key":"B7","series-title":"Health Promot Int","first-page":"349\u201364","article-title":"Health promotion glossary","volume":"13","author":"Nutbeam\n \nD","year":"1998"},{"issue":"(4):","key":"B8","series-title":"Pract Diab","first-page":"28\u201334","article-title":"Health literacy, self-management and glycaemic control in persons living with type 2 diabetes mellitus: a cross-sectional study","volume":"40","author":"Nugent\n \nTL","year":"2023"},{"issue":"(9):","key":"B9","series-title":"J Diabetes","first-page":"724\u201335","article-title":"The impact of health literacy interventions on glycemic control and self-management outcomes among type 2 diabetes mellitus: a systematic review","volume":"15","author":"Butayeva\n \nJ","year":"2023"},{"issue":"(3):","key":"B10","series-title":"Diabetes Technol Ther","first-page":"335\u201341","article-title":"Associations between health 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\nF","year":"2015;"},{"key":"B14","series-title":"Front Public Health","first-page":"692089","article-title":"Cross-sectional study on health literacy and internet accessibility among patients with DM in Gansu, China","volume":"9","author":"Zhao\n \nN","year":"2021"},{"issue":"(1):","key":"B15","series-title":"Health Educ Behav","first-page":"42\u201355","article-title":"Measuring health literacy in individuals with diabetes: a systematic review and evaluation of available measures","volume":"40","author":"Al Sayah\n \nF","year":"2012"},{"issue":"(1):","key":"B16","series-title":"Acta Diabetol","first-page":"1\u201312","article-title":"Health literacy in type 2 diabetes patients: a systematic review of systematic reviews","volume":"55","author":"Caruso\n \nR","year":"2018"},{"key":"B17","series-title":"Front Public Health","first-page":"1278614","article-title":"Prevalence and determinants of health literacy among the adult population of Qatar","volume":"11","author":"Ahmed\n \nS","year":"2023"},{"key":"B18","series-title":"Monthly figures on total population;","author":"Planning and Statistics Authority","year":"2023"},{"key":"B19","series-title":"ICD-10 : international statistical classification of diseases and related health problems : tenth revision","author":"World Health Organization","year":"2004"},{"key":"B20","series-title":"Version 2.3.1","article-title":"OpenEpi: open source epidemiologic statistics for public health;","author":"Dean\n \nA","year":"2013"},{"issue":"(4):","key":"B21","series-title":"Behav Res Methods","first-page":"1149\u201360","article-title":"Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses","volume":"41","author":"Faul\n \nF","year":"2009"},{"issue":"(2):","key":"B22","series-title":"Nurs Res","first-page":"E9\u201317","article-title":"Self-management behaviors, glycemic control, and metabolic syndrome in type 2 diabetes","volume":"69","author":"Ji\n \nM","year":"2020"},{"key":"B23","series-title":"World Data on Education Qatar","author":"United Nations Educational, Scientific, and Cultural Organization (UNESCO) International Bureau of Education","year":"2011"},{"key":"B24","series-title":"Obesity and overweight","author":"World Health Organization","year":"2021"},{"key":"B25","series-title":"Proceedings of the 6th Annual Health Literacy Research Conference","first-page":"3\u20134","article-title":"Measuring comprehensive health literacy in general populations: validation of instrument, indices and scales of the HLS-EU study Vienna Austria 6th Annual Health Literacy Research Conference Summary & Conclusions","author":"Pelikan\n \nJM","year":"2014;"},{"key":"B26","series-title":"BMC Public Health","first-page":"948","article-title":"Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q)","volume":"13","author":"S\u00f8rensen\n \nK","year":"2013"},{"key":"B27","series-title":"International Handbook of Health Literacy","first-page":"115\u201338","article-title":"Measuring health literacy in Europe: Introducing the European Health Literacy Survey Questionnaire (HLS-EU-Q)","author":"Pelikan\n \nJM","year":"2019"},{"key":"B28","series-title":"BMC Public Health","first-page":"1030","article-title":"Health literacy among refugees in Sweden - a cross-sectional study","volume":"14","author":"W\u00e5ngdahl\n \nJ","year":"2014"},{"issue":"(21):","key":"B29","series-title":"Int J Environ Res Public Health","first-page":"8181","article-title":"Psychometric assessment of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) for Arabic\/French-speaking migrants in Southern Europe","volume":"17","author":"Bas-Sarmiento\n \nP","year":"2020"},{"key":"B30","series-title":"Diabetes: An Old Disease, a New Insight","first-page":"42\u201350","article-title":"Type 2 diabetes mellitus, pandemic in 21st century","author":"Ginter\n \nE","year":"2013"},{"issue":"(5):","key":"B31","series-title":"PLoS One","first-page":"e0216402","article-title":"Prevalence of limited health literacy among patients with type 2 diabetes mellitus: a systematic review","volume":"14","author":"Abdullah\n \nA","year":"2019"},{"issue":"(1):","key":"B32","series-title":"PLoS One","first-page":"e0261430","article-title":"Correction: Prevalence of limited health literacy among patients with type 2 diabetes mellitus: a systematic review","volume":"17","author":"Abdullah\n \nA","year":"2022"},{"issue":"(4):","key":"B33","series-title":"JAMA","first-page":"475\u201382","article-title":"Association of health literacy with diabetes outcomes","volume":"288","author":"Schillinger\n \nD","year":"2002"},{"key":"B34","series-title":"Med J Islam Repub Iran","first-page":"230","article-title":"Health literacy and its influencing factors in Iranian diabetic patients","volume":"29","author":"Mohammadi\n \nZ","year":"2015"},{"issue":"(7):","key":"B35","series-title":"Saudi Med J","first-page":"675\u201380","article-title":"The association of health literacy with glycemic control in Saudi patients with type 2 diabetes","volume":"40","author":"Mashi\n \nAH","year":"2019"},{"issue":"(5):","key":"B36","series-title":"Saudi Med J","first-page":"465","article-title":"Effects of health literacy on type 2 diabetic patients\u2019 glycemic control, self-management, and quality of life","volume":"43","author":"ALSharit\n \nBA","year":"2022"},{"key":"B37","series-title":"Cad Saude Publica","first-page":"2021","article-title":"Avalia\u00e7\u00e3o da literacia para a sa\u00fade de pacientes portadores de diabetes acompanhados em um ambulat\u00f3rio p\u00fablico","volume":"37","author":"Pav\u00e3o\n \nALB","year":"2021;"},{"issue":"(7):","key":"B38","series-title":"PLoS One","first-page":"e0270161","article-title":"Diabetic health literacy and associated factors among diabetes mellitus patients on follow up at public hospitals, Bale Zone, South East Ethiopia, 2021","volume":"17","author":"Mogessie\n \nHM","year":"2022"},{"key":"B39","series-title":"Front Public Health","first-page":"1167807","article-title":"Epidemiological impact of public health interventions against diabetes in Qatar: mathematical modeling analyses","volume":"11","author":"Alareeki\n \nA","year":"2023"},{"key":"B40","series-title":"MOPH launches a groundbreaking national action plan to tackle obesity, diabetes, and ASCVD risks;","author":"Qatar News Agency","year":"2024"},{"key":"B1","series-title":"Diabetes Fact Sheet","author":"World Health Organization","year":"2021"},{"key":"B2","series-title":"Urgent action needed as global diabetes cases increase four-fold over past decades","author":"World Health Organization"},{"key":"B3","series-title":"Diabetes Res Clin Pract","first-page":"271\u201381","article-title":"IDF Diabetes Atlas: global estimates of diabetes prevalence for 2017 and projections for 2045","volume":"138","author":"Cho\n \nNH","year":"2018"},{"key":"B4","series-title":"Global Diabetes Data & Insights","article-title":"IDF Diabetes Atlas 2025 |","author":"International Diabetes Federation","year":"2025"},{"key":"B5","series-title":"Diabetes Res Clin Pract","first-page":"100\u20138","article-title":"Forecasting the burden of type 2 diabetes mellitus in Qatar to 2050: a novel modeling approach","volume":"137","author":"Awad\n \nSF","year":"2018"},{"issue":"(10):","key":"B6","series-title":"PLoS One","first-page":"e0259152","article-title":"Characterizing epidemiology of prediabetes, diabetes, and hypertension in Qataris: a cross-sectional study","volume":"16","author":"Al-Thani\n \nMH","year":"2021"},{"issue":"(4):","key":"B7","series-title":"Health Promot Int","first-page":"349\u201364","article-title":"Health promotion glossary","volume":"13","author":"Nutbeam\n \nD","year":"1998"},{"issue":"(4):","key":"B8","series-title":"Pract Diab","first-page":"28\u201334","article-title":"Health literacy, self-management and glycaemic control in persons living with type 2 diabetes mellitus: a cross-sectional study","volume":"40","author":"Nugent\n \nTL","year":"2023"},{"issue":"(9):","key":"B9","series-title":"J Diabetes","first-page":"724\u201335","article-title":"The impact of health literacy interventions on glycemic control and self-management outcomes among type 2 diabetes mellitus: a systematic review","volume":"15","author":"Butayeva\n \nJ","year":"2023"},{"issue":"(3):","key":"B10","series-title":"Diabetes Technol Ther","first-page":"335\u201341","article-title":"Associations between health literacy, diabetes knowledge, self-care behaviors, and glycemic control in a low income population with type 2 diabetes","volume":"13","author":"Bains\n \nS","year":"2011"},{"issue":"(1):","key":"B11","series-title":"BMC Public Health","first-page":"222","article-title":"Health literacy and medication adherence in adults from ethnic minority backgrounds with Type 2 Diabetes Mellitus: a systematic review","volume":"25","author":"Parmar\n \nJ","year":"2025"},{"issue":"(6):","key":"B12","series-title":"Aust J Prim Health","first-page":"526\u201333","article-title":"Association of health literacy and diabetes self-management: a systematic review","volume":"25","author":"Dahal\n \nPK","year":"2019"},{"issue":"(5):","key":"B13","series-title":"J Health Commun","first-page":"581\u20138","article-title":"Associations between health literacy and health outcomes in a predominantly low-income African American population with type 2 diabetes","volume":"20","author":"al Sayah\n \nF","year":"2015;"},{"key":"B14","series-title":"Front Public Health","first-page":"692089","article-title":"Cross-sectional study on health literacy and internet accessibility among patients with DM in Gansu, China","volume":"9","author":"Zhao\n \nN","year":"2021"},{"issue":"(1):","key":"B15","series-title":"Health Educ Behav","first-page":"42\u201355","article-title":"Measuring health literacy in individuals with diabetes: a systematic review and evaluation of available measures","volume":"40","author":"Al Sayah\n \nF","year":"2012"},{"issue":"(1):","key":"B16","series-title":"Acta Diabetol","first-page":"1\u201312","article-title":"Health literacy in type 2 diabetes patients: a systematic review of systematic reviews","volume":"55","author":"Caruso\n \nR","year":"2018"},{"key":"B17","series-title":"Front Public Health","first-page":"1278614","article-title":"Prevalence and determinants of health literacy among the adult population of Qatar","volume":"11","author":"Ahmed\n \nS","year":"2023"},{"key":"B18","series-title":"Monthly figures on total population;","author":"Planning and Statistics Authority","year":"2023"},{"key":"B19","series-title":"ICD-10 : international statistical classification of diseases and related health problems : tenth revision","author":"World Health Organization","year":"2004"},{"key":"B20","series-title":"Version 2.3.1","article-title":"OpenEpi: open source epidemiologic statistics for public health;","author":"Dean\n \nA","year":"2013"},{"issue":"(4):","key":"B21","series-title":"Behav Res Methods","first-page":"1149\u201360","article-title":"Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses","volume":"41","author":"Faul\n \nF","year":"2009"},{"issue":"(2):","key":"B22","series-title":"Nurs Res","first-page":"E9\u201317","article-title":"Self-management behaviors, glycemic control, and metabolic syndrome in type 2 diabetes","volume":"69","author":"Ji\n \nM","year":"2020"},{"key":"B23","series-title":"World Data on Education Qatar","author":"United Nations Educational, Scientific, and Cultural Organization (UNESCO) International Bureau of Education","year":"2011"},{"key":"B24","series-title":"Obesity and overweight","author":"World Health Organization","year":"2021"},{"key":"B25","series-title":"Proceedings of the 6th Annual Health Literacy Research Conference","first-page":"3\u20134","article-title":"Measuring comprehensive health literacy in general populations: validation of instrument, indices and scales of the HLS-EU study Vienna Austria 6th Annual Health Literacy Research Conference Summary & Conclusions","author":"Pelikan\n \nJM","year":"2014;"},{"key":"B26","series-title":"BMC Public Health","first-page":"948","article-title":"Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q)","volume":"13","author":"S\u00f8rensen\n \nK","year":"2013"},{"key":"B27","series-title":"International Handbook of Health Literacy","first-page":"115\u201338","article-title":"Measuring health literacy in Europe: Introducing the European Health Literacy Survey Questionnaire (HLS-EU-Q)","author":"Pelikan\n \nJM","year":"2019"},{"key":"B28","series-title":"BMC Public Health","first-page":"1030","article-title":"Health literacy among refugees in Sweden - a cross-sectional study","volume":"14","author":"W\u00e5ngdahl\n \nJ","year":"2014"},{"issue":"(21):","key":"B29","series-title":"Int J Environ Res Public Health","first-page":"8181","article-title":"Psychometric assessment of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) for Arabic\/French-speaking migrants in Southern Europe","volume":"17","author":"Bas-Sarmiento\n \nP","year":"2020"},{"key":"B30","series-title":"Diabetes: An Old Disease, a New Insight","first-page":"42\u201350","article-title":"Type 2 diabetes mellitus, pandemic in 21st century","author":"Ginter\n \nE","year":"2013"},{"issue":"(5):","key":"B31","series-title":"PLoS One","first-page":"e0216402","article-title":"Prevalence of limited health literacy among patients with type 2 diabetes mellitus: a systematic review","volume":"14","author":"Abdullah\n \nA","year":"2019"},{"issue":"(1):","key":"B32","series-title":"PLoS One","first-page":"e0261430","article-title":"Correction: Prevalence of limited health literacy among patients with type 2 diabetes mellitus: a systematic review","volume":"17","author":"Abdullah\n \nA","year":"2022"},{"issue":"(4):","key":"B33","series-title":"JAMA","first-page":"475\u201382","article-title":"Association of health literacy with diabetes outcomes","volume":"288","author":"Schillinger\n \nD","year":"2002"},{"key":"B34","series-title":"Med J Islam Repub Iran","first-page":"230","article-title":"Health literacy and its influencing factors in Iranian diabetic patients","volume":"29","author":"Mohammadi\n \nZ","year":"2015"},{"issue":"(7):","key":"B35","series-title":"Saudi Med J","first-page":"675\u201380","article-title":"The association of health literacy with glycemic control in Saudi patients with type 2 diabetes","volume":"40","author":"Mashi\n \nAH","year":"2019"},{"issue":"(5):","key":"B36","series-title":"Saudi Med J","first-page":"465","article-title":"Effects of health literacy on type 2 diabetic patients\u2019 glycemic control, self-management, and quality of life","volume":"43","author":"ALSharit\n \nBA","year":"2022"},{"key":"B37","series-title":"Cad Saude Publica","first-page":"2021","article-title":"Avalia\u00e7\u00e3o da literacia para a sa\u00fade de pacientes portadores de diabetes acompanhados em um ambulat\u00f3rio p\u00fablico","volume":"37","author":"Pav\u00e3o\n \nALB","year":"2021;"},{"issue":"(7):","key":"B38","series-title":"PLoS One","first-page":"e0270161","article-title":"Diabetic health literacy and associated factors among diabetes mellitus patients on follow up at public hospitals, Bale Zone, South East Ethiopia, 2021","volume":"17","author":"Mogessie\n \nHM","year":"2022"},{"key":"B39","series-title":"Front Public Health","first-page":"1167807","article-title":"Epidemiological impact of public 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